DR. OLUWASEUN ADELANKE ADETAYO M.D.
NPI 1710190285
Plastic Surgery in Loma Linda, CA

Active since May 08, 2007PECOS Enrolled
11234 ANDERSON ST, LLUMC HOUSE STAFF OFFICE CP 21005, LOMA LINDA, CA 92354(909) 558-4000 Get Directions Write a Review

NPPES record last updated: December 20, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Oluwaseun Adelanke Adetayo M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. OLUWASEUN ADELANKE ADETAYO M.D. (NPI 1710190285) is an individual plastic surgery provider in Loma Linda, California, licensed in Wisconsin (3829) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Neenah.

NPPES Registry Identity

NPI1710190285
Entity TypeIndividualFemale
Primary Taxonomy208200000X
Provider Legal NameDR. OLUWASEUN ADELANKE ADETAYOCredential: M.D.
Location Address11234 ANDERSON ST, LLUMC HOUSE STAFF OFFICE CP 21005Loma Linda, CA 92354-2804
Mailing Address11234 Anderson St, Llumc House Staff Office Cp 21005Loma Linda, CA 92354-2804
Sole ProprietorNo
Enumeration DateMay 8, 2007
Last NPPES UpdateDecember 20, 2023
NPPES CertifiedDecember 20, 2023
NPI 1710190285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License Licensed in WI · 3829
Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

11234 ANDERSON ST, Loma Linda, CA 92354

Secondary Practice Location 1

Location 1130 2nd StNeenah, WI 54956-2883 · Phone (920) 358-1223

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Oluwaseun Adelanke Adetayo M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92354 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant (Surgical)
11234 ANDERSON ST, RM 2562B
LOMA LINDA, CA 92354
Pediatrics (Pediatric Emergency Medicine)
11234 ANDERSON ST, A 108
LOMA LINDA, CA 92354
Radiology (Radiation Oncology)
11234 ANDERSON ST, SUITE B-121
LOMA LINDA, CA 92354
Nurse Practitioner (Pediatrics)
11234 ANDERSON ST
LOMA LINDA, CA 92354
Nurse Practitioner (Pediatrics)
11234 ANDERSON ST, MC 5700H
LOMA LINDA, CA 92354
Internal Medicine (Cardiovascular Disease)
11234 ANDERSON ST
LOMA LINDA, CA 92354
Nurse Practitioner
11234 ANDERSON ST, ROOM 6700H
LOMA LINDA, CA 92354
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1710190285, enumerated as an "individual" on May 08, 2007.

The provider is located at 11234 ANDERSON ST LLUMC HOUSE STAFF OFFICE CP 21005 LOMA LINDA, CA 92354 and the phone number is (909) 558-4000.

Plastic Surgery with taxonomy code 208200000X.

The provider might be accepting Accepts: CareSource (Common Ground Healthcare) and Network. Please consult your insurance carrier or call the provider to verify.